Adoption and Practice Patterns of TG-263 Standardized Nomenclature for Breast Radiation Therapy in a Statewide Quality Consortium.

PURPOSE: To assess the compliance rates of a national nomenclature standard (TG-263) in a collaborative quality consortium to determine compliance trends over time and the impact of insurance-based incentive programs on adoption, common naming errors, and differences in compliance between teaching and non-teaching centers for breast radiation therapy.

MATERIALS/

METHODS

DICOM submissions were used to verify TG-263 compliance of breast treatment plan structures for the breast target volumes, surgical bed, heart, and ipsilateral lung. Annual compliance rates were analyzed using the Cochran-Armitage test, and rates were summarized across 29 participating centers and compared between teaching and non-teaching centers.

RESULTS

TG-263 naming practice patterns were analyzed for 12,853 patients receiving breast radiation therapy at teaching and non-teaching centers between 2018 and 2024. The PTV_Breast_L/R compliance improved from 85.2% to 97.1% from 2018 to 2024. PTVsb compliance increased from 86.5% to 90.9% from 2018 to 2024. In 2024, a difference in compliance was only observed for PTV_Breast_L/R, with rates of 91.1% and 97.7% for teaching and non-teaching centers, respectively. Compliance with naming both PTV_Breast_L/R and PTVsb correctly was 77.2% in 2018 and 89.4% in 2024. The most common non-compliant structure name that was submitted was 'PTV_Boost_L/R'.

CONCLUSION

This study shows that initiatives can be used to improve TG-263 compliance and thus enhance terminology adoption and inter- and intra- clinical communication, which is maintained after the incentives end.